The specific aims for the project are 1) to develop technical quality of care measures for asthma that are valid, reliable, sensitive and specific and have predictive value related to asthma outcomes, and can be easily and inexpensively applied in the health care setting used, 2) to assess whether the technical quality of care measures for asthma can be applied to inpatient and outpatients in the health care setting used 3) to assess whether the technical qualith of care measures for asthma can be applied accross the fee for service, managed care organization, Medicaid, and Medicare payment systems in the health care setting used, and 4) to develop a model system to identify technical quality of care measures for other chronic medical conditions, involving the settings outlined in specific aims 2 and 3 in the health care setting used.